Qiu Y, Zhu X, Wang W, Xu Q, Ding Y
Department of Hepatobiliary Surgery, Affiliated Drum Tower Hospital, Medical School of Nanjing University, Zhongshang Road 321, Nanjing 210008, China.
Transplant Proc. 2009 Dec;41(10):4232-7. doi: 10.1016/j.transproceed.2009.08.076.
The effect of total parenteral nutrition (TPN) support supplemented with alanyl-glutamine (Ala-Gln) dipeptide was investigated in a randomized, controlled clinical trial.
Sixty-five patients with the diagnosis of end-stage liver disease or hepatic cellular carcinoma admitted for orthotopic liver transplantation were randomly divided into 3 groups: diet group (n = 21), TPN group (n = 22), and Gln group (n = 22). Patients in the TPN and Gln groups received isocaloric and isonitrogenous TPN for 7 days. Venous heparin blood samples were obtained for assay on days 2 and 9 after surgery; we performed routine pathologic tests.
Compared with the results on day 9 in the TPN group, there was a significant increase in the prognostic nutrition index and in prealbumin among the Gln group. Aspartate aminotransferase improved significantly by Gln treatment compared with traditional TPN support (P < .05). The pathologic results also showed Gln supplementation to reduce hepatic cell injury. A significant decrease in postoperative hospital stay was observed in the Gln group.
Posttransplant TPN support greatly improved protein metabolism and nutritional state of patients. TPN with Ala-Gln helped to improve synthetic function and to reduce the injury to a transplanted liver.
在一项随机对照临床试验中研究补充丙氨酰谷氨酰胺（Ala-Gln）二肽的全胃肠外营养（TPN）支持的效果。
65例诊断为终末期肝病或肝细胞癌并接受原位肝移植的患者被随机分为3组：饮食组（n = 21）、TPN组（n = 22）和谷氨酰胺组（n = 22）。TPN组和谷氨酰胺组患者接受等热量、等氮量的TPN治疗7天。术后第2天和第9天采集静脉肝素化血样进行检测；我们进行了常规病理检查。
与TPN组术后第9天的结果相比，谷氨酰胺组的预后营养指数和前白蛋白显著增加。与传统TPN支持相比，谷氨酰胺治疗使天冬氨酸转氨酶显著改善（P < .05）。病理结果也显示补充谷氨酰胺可减轻肝细胞损伤。谷氨酰胺组术后住院时间显著缩短。
移植后TPN支持极大地改善了患者的蛋白质代谢和营养状况。含Ala-Gln的TPN有助于改善合成功能并减轻对移植肝脏的损伤。
